Mortality prognostic factors of COVID-19 in the emergency department during outbreak in Daegu, Korea: a multicenter retrospective study

Kim, Jong-yeon; Kim, Jung Ho; Ryoo, Hyun Wook; Ahn, Jae Yun; Moon, Sungbae; Lee, Dong Eun; Lee, Sang Hun; Mun, You Ho; Jang, Tae Chang

J Korean Soc Emerg Med > Volume 33(1); 2022 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2022;33(1): 94-105.

Mortality prognostic factors of COVID-19 in the emergency department during outbreak in Daegu, Korea: a multicenter retrospective study

¹Department of Public Health, Kyungpook National University Hospital, Daegu, Korea
²Department of Emergency Medicine, Yeungnam National University Hospital, Daegu, Korea
³3 Department of Emergency Medicine, Kyungpook National University Hospital, Daegu, Korea
⁴Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
⁵Department of Emergency Medicine, Kyungpook National University Dongsan Hospital, Daegu, Korea
⁶Department of Emergency Medicine, Daegu Catholic University Hospital, Daegu, Korea

Correspondence

Jung Ho Kim ,Tel: 053-620-3191, Fax: 053-624-8030, Email: jhkimem@naver.com,

Received: January 26, 2021; Revised: March 29, 2021 Accepted: April 6, 2021. Published online: February 28, 2022.

ABSTRACT

Objective:
We aimed to investigate the characteristics and prognostic factors of coronavirus disease 2019 (COVID-19) patients in the emergency departments (EDs) in Daegu, Korea, the region with the second regional outbreak worldwide.
Method:
We conducted a retrospective observational multicenter study using a population-based COVID-19 registry of EDs. We included the demographic, clinical and laboratory data. Cox proportional hazard regression analysis was performed to identify the prognostic factors of mortality.
Results:
A total of 241 patients were included in this study. In the Cox hazard regression model (hazard ratio [95% confidence interval]), age (65-79 years: 3.531 [1.529-8.156], ≥80 years: 5.335 [2.229-12.770]), respiratory rate (RR) (>20 breaths/min: 2.025 [1.205-3.403], ≤11 breaths/min: 111.292 [30.845-401.555]), lymphocyte counts <1.0×10⁹/L (2.611 [1.494-4.739]), blood urea nitrogen (BUN) levels>23 mg/dL (2.047 [1.233-3.399]), aspartate aminotransferase (AST) levels>40 IU/L (1.785 [1.009-3.158]) and neutrophil counts>6.3×10⁹/L (1.638 [1.014-2.644]) were associated with mortality.
Conclusion:
Age, RR, lymphocyte counts, BUN levels, AST levels and neutrophil counts were prognostic factors in COVID-19 patients in the ED. These factors can help effectively treat and reduce mortality through optimized management of COVID-19 patients, in places with limited emergency medical resources such as massive regional outbreaks.

Key words: Coronavirus; Disease outbreaks; Emergency treatment; Prognosis; Mortality